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An illegal choice has been detected. Please contact the site administrator.Documents Center
Reports, Forms, Pamphlets and Policies
You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Find a Document
- Click on the tab that corresponds with the type of document type you are looking for, or click on the "All Documents" tab to search through all available documents. You can refine your search by selecting a category from the Filter by Category drop-down.
- Type in a number or keyword in the "Search by Name, Number, or Keyword" box and click the Search button. When searching for a document by the exact title (form name), place the title within quotation marks.
- You can click on the column headers to sort the search results.
| Number | Document Name | Effective Date |
|---|---|---|
| FAA-0155B | Determination of Primary Wage Earner (PWE) | 06/01/2023 |
| FAA-1111A-XLP | Participant Statement Verification Worksheet (Extra Large Print) | 06/01/2023 |
| FAA-0059A-S | Autoridad para Divulgar Expedientes | 06/01/2023 |
| FAA-1111A-SXLP | Formulario para Verificar la Declaración del Participante (Letra extra grande) | 06/01/2023 |
| FAA-0155A-S | Antecedentes de Empleo o Capacitación Reciente | 06/01/2023 |
| FAA-1111A-SLP | Formulario para Verificar la Declaración del Participante (Letra grande) | 06/01/2023 |
| CCA-1105A | Tax Claimant Questionnaire | 06/01/2023 |
| FAA-0155B-S | Determinación de Principal Devengador(a) de Ingresos (PWE por sus siglas en inglés) | 06/01/2023 |
| FAA-1529A | Verification of Volunteers Hours | 06/01/2023 |
| FAA-1439A | Self-Employment Income Statement (English) | 06/01/2023 |
| Number | Document Name | Effective Date |
|---|---|---|
| UB-092-A | Confidential Financial Statement (English) | 03/01/2018 |
| UB-130A-S | Work History (Spanish) | 03/01/2018 |
| UC-514 | Report of Changes Form (English) | 03/01/2018 |
| DDD-1651A | COBV Waiver Request (English) | 03/01/2018 |
| DD-099-B | Pre-PAS Screening Tool for Members at Least 2 Years 10 Months Old, But Less than 6 Years Old | 03/01/2018 |
| UB-092-A-S | Confidential Financial Statement (Spanish) | 03/01/2018 |
| DD-099-C | Pre-PAS Screening Tool Only for Members between 6 and 11 Years Old | 03/01/2018 |
| UIA-1004A | Bulk Filer Application | 03/01/2018 |
| DD-099-D | Pre-PAS Screening Tool for Members At Least 12 Years Old | 03/01/2018 |
| CSE-1284A | Parent’s agreement to be bound by genetic test results (English/Spanish) | 02/01/2018 |
No results available.
Arizona State Resources
Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. The process for requesting a reasonable modification can be found at Equal Opportunity and Reasonable Modification
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